MEDICARE: DR. MICHAEL JOSEPH GABRIEL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	14111	NC

General Provider Information

NPI Number	:	1578632345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOSEPH GABRIEL PHARMD

Provider Business Mailing Address
First Line	:	211 N DOTGER AVE
Second Line	:	D-3
City	:	CHARLOTTE
State	:	NC
Zip	:	28207-2052
Country	:	US
Telephone Number	:	704-516-7766
Fax Number	:

Provider Business Practice Location Address
First Line	:	2133 SHAMROCK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-2132
Country	:	US
Telephone Number	:	704-563-2286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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